The comparison of clinical signs presentation in middle age men and women with myocardial infarction

Abstract Background To analyze incidence, use of therapeutic procedures, and in-hospital outcomes in patients with ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) according to the presence of type 2 diabetes (T2DM) in Spain (2016–2018) and to investigate sex differences. Methods Using the Spanish National Hospital Discharge Database, we estimated the incidence of myocardial infarctions (MI) in men and women with and without T2DM aged ≥ 40 years. We analyzed comorbidity, procedures, and outcomes. We matched each man and woman with T2DM with a non-T2DM man and woman of identical age, MI code, and year of hospitalization. Propensity score matching was used to compare men and women with T2DM. Results MI was coded in 109,759 men and 44,589 women (30.47% with T2DM). The adjusted incidence of STEMI (IRR 2.32; 95% CI 2.28–2.36) and NSTEMI (IRR 2.91; 95% CI 2.88–2.94) was higher in T2DM than non-T2DM patients, with higher IRRs for NSTEMI in both sexes. The incidence of STEMI and NSTEMI was higher in men with T2DM than in women with T2DM. After matching, percutaneous coronary intervention (PCI) was less frequent among T2DM men than non-T2DM men who had STEMI and NSTEMI. Women with T2DM and STEMI less frequently had a code for PCI that matched that of non-T2DM women. In-hospital mortality (IHM) was higher among T2DM women with STEMI and NSTEMI than in matched non-T2DM women. In men, IHM was higher only for NSTEMI. Propensity score matching showed higher use of PCI and coronary artery bypass graft and lower IHM among men with T2DM than women with T2DM for both STEMI and NSTEMI. Conclusions T2DM is associated with a higher incidence of STEMI and NSTEMI in both sexes. Men with T2DM had higher incidence rates of STEMI and NSTEMI than women with T2DM. Having T2DM increased the risk of IHM after STEMI and NSTEMI among women and among men only for NSTEMI. PCI appears to be less frequently used in T2DM patients After STEMI and NSTEMI, women with T2DM less frequently undergo revascularization procedures and have a higher mortality risk than T2DM men.

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Contemporary Determinants of Delayed Benchmark Timelines in Acute Myocardial Infarction in Men and Women

The American Journal of Cardiology ◽

10.1016/j.amjcard.2017.07.085 ◽

2017 ◽

Vol 120 (10) ◽

pp. 1715-1719 ◽

Cited By ~ 5

Author(s):

Hilmi Alnsasra ◽

Doron Zahger ◽

Diklah Geva ◽

Shlomi Matetzky ◽

Roy Beigel ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Men And Women

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Case - Control Study of Nonfatal Myocardial Infarction in Relation to Selected Foods in Japanese Men and Women

Japanese Circulation Journal ◽

10.1253/jcj.65.200 ◽

2001 ◽

Vol 65 (3) ◽

pp. 200-206 ◽

Cited By ~ 48

Author(s):

Shizuka Sasazuki ◽

the Fukuoka Heart Study Group

Keyword(s):

Myocardial Infarction ◽

Case Control Study ◽

Case Control ◽

Nonfatal Myocardial Infarction ◽

Japanese Men ◽

Men And Women ◽

Control Study

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Abstract 17356: Gender Differences in Clinical Presentation and Outcomes of Patients With Acute Myocardial Infarction and Spontaneous Coronary Artery Dissection: A Nationwide Inpatient Sample Matched Analysis

Circulation ◽

10.1161/circ.138.suppl_1.17356 ◽

2018 ◽

Vol 138 (Suppl_1) ◽

Author(s):

Setri Fugar ◽

Juliet A Yirerong ◽

Alfred Solomon ◽

Ahmed A Kolkailah ◽

Tauseef Akthar ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Gender Differences ◽

Clinical Presentation ◽

Artery Dissection ◽

P Value ◽

Spontaneous Coronary Artery Dissection ◽

Coronary Artery Dissection ◽

Men And Women ◽

Significant Difference

Introduction: Spontaneous Coronary Artery Dissection (SCAD) is reported to occur predominantly in young women. Gender differences in the clinical presentation and outcomes of patients with SCAD have not been studied on a population level. We sought to compare the in-hospital outcomes of men and women presenting with acute myocardial infarction (AMI) and SCAD. Methods: We identified patients from the National Inpatient Sample (NIS) between 2005 and 2015 who presented with primary diagnoses of AMI and SCAD. We identified SCAD with ICD-9 code 414.12. A 1:1 propensity-matched cohort was created to examine the outcomes between men and women. Primary endpoint was in-hospital mortality. Secondary endpoints included in-hospital cardiac and non-cardiac complications. Results: Of the 6617 (32017 weighted national estimates) patients with SCAD over the study period, majority were males 3667 (55.4%). Males were younger than females (60.32 yr vs. 61.59 yr) and presented more often with ST-elevation myocardial infarction (STEMI) (53.0% vs. 45.9% P=<0.001). Propensity matching yielded 2366 males and 2366 females. In the matched group, there was no significant difference in in-hospital mortality between males and females (OR 1.20 95% CI -0.93-1.54). With regards to in-hospital complications, ventricular tachycardia (V-Tach) was significantly less frequent in females as compared to males (8.0% vs. 10.1% OR 0.76 p-value 0.003). There was no significant difference between females and males in the frequency of other complications, including intracranial hemorrhage (0.2% vs 0.2% OR 1.45 p-value 0.50), GI bleed (1.8% vs 1.3% OR 1.35 p-value 0.13), cardiogenic shock (9.8% vs 9.7% OR 1.01 p-value 0.86), acute heart failure (3% vs 2.6% OR 1.18 p-value 0.26), ventricular fibrillation(vfib) (5.6% vs 6.0% OR 0.928 p-value 0.48) or stroke ( 1.5% vs 1.0% OR 1.535 p-value 0.06) Conclusion: In our large population-based analysis, compared to females, males were more likely to present with STEMI as compared to females. With the except of V-Tach, which was higher in males, there were no significant gender differences in hospital outcomes namely inpatient mortality, cardiogenic, Vfib or acute heart failure.

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PROGRESSIVE ATHEROSCLEROTIC CORONARY ARTERIES IN PATIENTS WITH SEVERAL ISCHEMIC EVENTS IN ANAMNESIS

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2021-23-9-113-119 ◽

2021 ◽

pp. 113-119

Author(s):

Parkhomenko O.M. ◽

Lozhkina N.G.

Keyword(s):

Myocardial Infarction ◽

Coronary Arteries ◽

Clinical Signs ◽

Risk Groups ◽

Adverse Outcomes ◽

Syntax Score ◽

One Year ◽

The Moment ◽

Microsoft Office ◽

Ischemic Events

Вackground. Progressive atherosclerosis is accompanied by unfavorable clinical outcomes; study and understanding of this process is necessary to identify the appropriate risk groups. Purpose of the study to study the dynamics of atherosclerotic lesions of the coronary arteries in patients with several ischemic events in history. Patient Characterization and Research Methods. The present subanalysis included 51 patients with recurrent nonfatal myocardial infarction (MI) out of the initially included 100 patients with index MI. All 100 patients had a history of two or more ischemic coronary or cerebral events, which corresponds to the clinical signs of progressive atherosclerosis. The dynamics of the degree of coronary stenosis from the moment of index MI to repeated MI was assessed according to the data of selective coronary angiography. The statistical program Microsoft Office Excel 2019 was used. Results. All patients with recurrent myocardial infarction (51 people) had signs of progression of coronary artery stenosis: "mild" progression - 82.3%, "moderate" and "severe" - 15.6% and 2.1%, respectively. SYNTAX Score> 22.5 points was a predictor of one-year adverse outcomes: OR 6.349, CI (2.548-15.823). The results obtained make it possible to distinguish a group of patients with accelerated atherosclerosis syndrome in order to stratify the risk and optimally manage this complex category of patients.

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Abstract P359: Cardiovascular Risk Factor and Diseases in the Italian Adult Population: The National Health Examination Surveys 2008-2012

Circulation ◽

10.1161/circ.127.suppl_12.ap359 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Chiara Donfrancesco ◽

Luigi Palmieri ◽

Cinzia Lo Noce ◽

Francesco Dima ◽

Amalia De Curtis ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Risk Factor ◽

Adult Population ◽

Smoking Habit ◽

Participation Rate ◽

Health Examination ◽

Biochemical Tests ◽

Men And Women ◽

Italian Regions

Background: From 2008 to 2012 an Health Examination Survey (HES)-Osservatorio Epidemiologico Cardiovascolare (OEC) has been implemented in Italy with the aim of assessing cardiovascular (CV) risk factors, prevalence of risk conditions and CV diseases for the Italian adult population. Methods: Random samples of general population stratified by age and sex were examined in all Italian regions (participation rate 56%). Risk factor were collected using standardized procedures and methods; biochemical tests were assayed in a central laboratory; a questionnaire investigates behaviours and CVD history; a ECG read in Minnesota code was used to define previous myocardial infarction. Comparisons between men and women were assessed using t-test for means and chi-squared test for prevalence. Results: Data of 4371 men and 4339 women ages 35-79 years were analysed. Majority of risk factors mean levels resulted higher in men than in women: systolic blood pressure (SBP) was 134 mmHg and 129 mmHg (p<0.0001), diastolic (DBP) was 84 mmHg and 79 mmHg (p<0.0001), fasting plasma glucose was 103 mg/dl and 95 mg/dl (p<0.0001), triglycerides was 135 mg/dl and 108 mg/dl (p<0.0001), respectively; as well as many CV risk conditions: smoking habit was 21% in men and 18% in women (p<0.0001), diabetes was 14% in men and 9% in women (p<0.0001) (28% of diabetic unaware both in men and women), 56% of men and 43% of women have SBP>=140 mmHg or DBP>=90 mmHg or in treatment (p<0.0001), 65% of men and 70% of women have total cholesterol (TC) >=200 mg/dl or in treatment for (p<0.0001), 48% of men and 33% of women are in overweight (BMI 25-29 kg/m 2 ) (p<0.0001). TC, LDL and HDL cholesterol resulted lower in men than in women: 209 mg/dl and 218 (44) (p<0.0001), 131 (38) mg/dl and 134 mg/dl (p<0.0001), 51 mg/dl and 62 mg/dl (p<0.0001), respectively. As well as prevalence of physical inactivity during leisure time: 31% in men and 43% in women (p<0.0001). Prevalence of obesity (BMI>=30 kg/m 2 ) resulted similar in men and women: 25% and 27% respectively (p=0.0818). Prevalence of myocardial infarction was 2.1% in men and 0.7% in women (p<0.0001), prevalence of by-pass or angioplasty surgery was 5.1% and 1.0% (p<0.0001), prevalence of angina pectoris was 3.2% and in 4.8% (p<0.0001), respectively. Conclusions: At present obesity and smoking are still a priority in public health. In combination with other information sources, the OEC can contribute greatly to plan community actions and health services at national and regional level.

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